June 28, 2011

The international PR firm Ogilvy has just released a study prescribing a shift in healthcare marketing from the exploitation of clinical breakthroughs to something Ogilvy calls "sustainability." They're not talking about the sort of sustainability we in healthcare usually mean, such as the sustainability of a health information exchange's business model. Instead, they're suggesting that we start selling green.

Companies with strong environmental competencies will rule the market in the coming years, say the investigators, Jeff Chertack and Monique da Silva. In an op-ed by Chertack, he says that "[the new] value will be delivered by new healthcare products and delivery systems that help society adapt to and thrive in changing climate and disease patterns."

CarePrecise Technology made a move in the past year toward eliminating a large part of its carbon footprint by shifting even our largest file deliveries from physical (DVD disks) to virtual. All new product sales are now 100% virtual, and as subscribers renew, their deliveries will be virtual as well. Not only has the shift reduced fuel and materials consumption, but products are now delivered in less than half the time. In a business where the freshness of data is crucial, every hour counts. CarePrecise's NPI directory unit, NPIdentify, has produced state NPI directories in electronic form only since 2007.

CarePrecise's data center is a shared environment, utilizing hyper-efficient cloud computing resources. Except for certain mission-critical operations performed on in-building platforms, all front-end operations and many back-office computing tasks have been moved to the cloud, dramatically reducing office space utilization and fuel consumption.

Whether the healthcare industry in specific, and the broader business community in general, will effectively turn environmental competencies into profits is still an open question. Certainly, entities like hospitals make huge impacts and consume enormous resources (think about all those disposables and all those sheets washed after 30 minutes of use, pillows, trays and pitchers discarded after each patient...), and spectacular improvements could be made. Vendors who help these organizations green up are offering a new way to compete for patients. The competitive advantage offered by corporate carbon consciousness could be tomorrow's marketing edge for providers and their vendors.

June 9, 2011

When the NPI Final Rule (and all of its after-final rules) created the National Plan and Provider Enumeration System, there were many unknowns: Which datapoints would be released for the industry to use? loomed large. But another issue has come home to roost.

Organizations (Type 2 providers under the rule) were permitted to have as many NPI numbers as they liked, and they could structure their assignment of NPIs any which way. For instance, one hospital might get separate NPI numbers for each of its business units, while another got and NPI for each of its physical locations, another for each of the cluster of corporations, while some clever hospitals got an NPI for each reimbursement channel. And then of course, some hospitals got just one.

No problem with that -- the various business optimization strategies are interesting to observe, and surely make sense in their various contexts. The problem is that there is no primary NPI number per hospital or health system. That is to say, there is no way to know from the NPPES records which if any of the NPI records is a parent, and which is a child. Oh, of course, an army of human analysts can pore over the records and find 37 hospital NPI records each identifying, say, Mayonaise Health System as its parent. But a computer finds that task a bit difficult, since it will find many variations in the records, e.g.,

Mayonaise Hospital

Mayonaise Health System

Mayo Hospital

Mayo Hospitals

Mayonaise Hospitals

Miracle Whip Health

and on an on

Thus, it becomes essentially impossible to say how many hospitals there are, even though we are looking at the complete set of federal records on hospitals. Had there been a primary or master NPI required for each General acute care hospital -- regardless of how many business units and other NPIs are involved, it would be possible to perform much more significant research on hospital service areas, densities, availability of care, duplication of services, and much more. (We've just started putting state-by-state physician and hospital counts on our home page at CarePrecise.com, but for now, we are able only to show the total of all hospital records -- 29,946 at present -- which is far more than the roughly 5,000 actual hospitals to whom all those records belong.)

The coyness built into the NPPES was more or less deliberate. American hospitals are a contentious lot, engaging in constant competition, and they did not want any more known about them than absolutely necessary. Coy data costs everyone money, and adds opacity to the healthcare system. Still, with the HospitalCompare project and our subsequent mining of all of these data sources, much can be learned, and the reach of each hospital organization can ultimately be published. Stay tuned.